Skip to main content
SpringerLink
Log in

How Digital Health Will Deliver Precision Medicine

  • Chapter
  • First Online:
Book cover Digital Health

Part of the book series: Health Informatics ((HI))

Abstract

Digital health can be briefly described as the intersect between smartphone-enabled mobile computational and connectivity capabilities, but also encompass genomics, information systems, wireless sensors, cloud computing and machine learning with modern healthcare. Globally, we are seeing an increase in the desire for patients to play an active role in their healthcare management. Combined, digital technology and patient engagement, advances the possibility of providing personalised medicine. This entails tailoring the medical experience to an individual patient, based on their genetics, molecular, physiologic and cellular analysis in addition to their socio-demographics and personal history. Advancements in this field have seen digital health being incorporated into a variety of aspects of healthcare: including diagnosis, management and follow-up of patients. However, many challenges still exist preventing their disseminated use, including security concerns as well a lack of evidence base demonstrating both clinical and cost effectiveness.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

References

  • Anderson JL, Horne BD, Stevens SM, Grove AS, Barton S, Nicholas ZP, et al. Randomized trial of genotype-guided versus standard warfarin dosing in patients initiating oral anticoagulation. Circulation. 2007;116(22):2563–70.

    Article  CAS  PubMed  Google Scholar 

  • Bajtarevic A, Ager C, Pienz M, Klieber M, Schwarz K, Ligor M, et al. Noninvasive detection of lung cancer by analysis of exhaled breath. BMC Cancer. 2009;9(1):164–16.

    Article  Google Scholar 

  • DiCarlo LA, Weinstein RL, Morimoto CB, Savage GM, Moon GL, Au-Yeung K, et al. Patient-centered home care using digital medicine and telemetric data for hypertension: feasibility and acceptability of objective ambulatory assessment. J Clin Hypertens (Greenwich). 2016;18:n/a.

    Article  Google Scholar 

  • Espay AJ, Bonato P, Nahab FB, Maetzler W, Dean JM, Klucken J, et al. Technology in Parkinson's disease: challenges and opportunities. Mov Disord. 2016;31(9):1272–82. doi:10.1002/mds.26642.

  • Evaluation of Genomic Applications in Practice and Prevention (EGAPP) Working Group. Recommendations from the EGAPP working group: testing for cytochrome P450 polymorphisms in adults with nonpsychotic depression treated with selective serotonin reuptake inhibitors. Genet Med. 2007:819–25.

    Google Scholar 

  • Godbehere P, Wareing P. Hypertension assessment and management: role for digital medicine. J Clin Hypertens. 2014;16(3):235.

    Article  Google Scholar 

  • Heldberg BE, Kautz T, Leutheuser H, Hopfengartner R, Kasper BS, Eskofier BM. Using wearable sensors for semiology-independent seizure detection - towards ambulatory monitoring of epilepsy. Conf Proc IEEE Eng Med Biol Soc. 2016;2015:593–6.

    Google Scholar 

  • Holtz B, Whitten P. Managing asthma with mobile phones: a feasibility study. Telemed J E-Health. 2009;15(9):907–9.

    Article  PubMed  Google Scholar 

  • Hulot J-S, Bura A, Villard E, Azizi M, Remones V, Goyenvalle C, et al. Cytochrome P450 2C19 loss-of-function polymorphism is a major determinant of clopidogrel responsiveness in healthy subjects. Blood. 2006;108(7):2244–7.

    Article  CAS  PubMed  Google Scholar 

  • International Warfarin Pharmacogenetics Consortium. Estimation of the warfarin dose with clinical and pharmacogenetic data. N Engl J Med. 2009;360(8):753–64.

    Article  Google Scholar 

  • Kvedar JC, Fogel AL, Elenko E, Zohar D. Digital medicine’s march on chronic disease. Nat Biotechnol. 2016;34(3):239–46.

    Article  CAS  PubMed  Google Scholar 

  • Lai SY, Deffenderfer OF, Hanson W, Phillips MP, Thaler ER. Identification of upper respiratory bacterial pathogens with the electronic nose. Laryngoscope. John Wiley & Sons Inc. 2002;112(6):975–9.

    Article  PubMed  Google Scholar 

  • Lanham KJ, Oestreich JH, Dunn SP. Impact of genetic polymorphisms on clinical response to antithrombotics. Pharmacogenomics Pers Med. 2010;3:87–99.

    Article  CAS  Google Scholar 

  • Lowres N, Neubeck L, Salkeld G, Krass I, McLachlan AJ, Redfern J, et al. Feasibility and cost-effectiveness of stroke prevention through community screening for atrial fibrillation using iPhone ECG in pharmacies. Thromb Haemost. 2014;111(6):1167–76.

    Article  CAS  PubMed  Google Scholar 

  • Lumley T, Rice K. Potential for revealing individual-level information in genome-wide association studies. JAMA. 2010;303(7):659–60.

    Article  CAS  PubMed  Google Scholar 

  • Mach KE, Wong PK, Liao JC. Biosensor diagnosis of urinary tract infections: a path to better treatment? Trends Pharmacol Sci. 2011;32(6):330–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Maetzler W, Domingos J, Srulijes K, Ferreira JJ, Bloem BR. Quantitative wearable sensors for objective assessment of Parkinson’s disease. Mov Disord. 2013;28(12):1628–37.

    Article  PubMed  Google Scholar 

  • Manolio TA. Genome wide association studies and assessment of the risk of disease. N Engl J Med. 2010;363(2):166–76.

    Article  CAS  PubMed  Google Scholar 

  • Naik R, Macey N, West RJ. An ingestible sensor and wearable patch tracking adherence and activity patterns identified underlying factors leading to persistent hypertension: a real-world registry study. 2015.

    Google Scholar 

  • Nickels A, Dimov V. Innovations in technology: social media and mobile technology in the care of adolescents with asthma. Curr Allergy Asthma Rep. 2012;12(6):607–12.

    Article  PubMed  Google Scholar 

  • Noble K, Xiang P, Kim Y, Leadley S, Dicarlo L. Medication adherence and activity patterns measured by sensor technologies guided hypertension management in the community pharmacy. Pharmacotherapy: The Journal Of Human Pharmacology and Drug Therapy. 2015; 35(11):e180.

    Google Scholar 

  • Oliver N, Flores-Mangas F. HealthGear: a real-time wearable system for monitoring and analyzing physiological signals. InWearable and Implantable Body Sensor Networks, 2006. BSN 2006. International Workshop on 2006; p. 4. IEEE.

    Google Scholar 

  • Pai NP, Vadnais C, Denkinger C, Engel N, Pai M. Point-of-care testing for infectious diseases: diversity, complexity, and barriers in low- and middle-income countries. PLoS Med. 2012;9(9):e1001306–7.

    Article  PubMed  PubMed Central  Google Scholar 

  • Pierce BL, Ahsan H. Clinical assessment incorporating a personal genome. Lancet. 2010;376(9744):869–70.

    Article  PubMed  Google Scholar 

  • Pulley JM, Denny JC, Peterson JF, Bernard GR, Vnencak-Jones CL, Ramirez AH, et al. Operational implementation of prospective genotyping for personalized medicine: the design of the Vanderbilt PREDICT project. Clin Pharmacol Ther. 2012;92(1):87–95.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Quinn CC, Shardell MD, Terrin ML, Barr EA. Cluster-randomized trial of a mobile phone personalized behavioral intervention for blood glucose control. Diabetes Care. 2011;34:1934–42.

    Article  PubMed  PubMed Central  Google Scholar 

  • Rappaport KM, McCracken CC, Beniflah J, Little WK, Fletcher DA, Lam WA, et al. Assessment of a smartphone otoscope device for the diagnosis and management of otitis media. Clin Pediatr (Phila). 2015;7:1–11.

    Google Scholar 

  • Ryan D, Cobern W, Wheeler J, Price D, Tarassenko L. Mobile phone technology in the management of asthma. J Telemed Telecare. 2005;11 Suppl 1(5):43–6. SAGE Publications

    Article  CAS  PubMed  Google Scholar 

  • Sepah SC, Jiang L, Peters AL. Long-term outcomes of a web-based diabetes prevention program: 2-year results of a single-arm longitudinal study. J Med Internet Res. 2015;17(4):e92–8.

    Article  PubMed  PubMed Central  Google Scholar 

  • Shaffer DW, Kigin CM, Kaput JJ, Gazelle GS. What is digital medicine? Stud Health Technol Inform. 2002;80:195–204.

    PubMed  Google Scholar 

  • Steinhubl SR, Muse ED, Topol EJ. The emerging field of mobile health. Sci Transl Med. 2015;7(283):283rv3.

    Article  PubMed  PubMed Central  Google Scholar 

  • Steinhubl SR, Muse ED, Barrett PM, Topol EJ. Off the cuff: rebooting blood pressure treatment. Lancet. 2016;388:749.

    Article  PubMed  Google Scholar 

  • Strong K, Mathers C, Leeder S, Beaglehole R. Preventing chronic diseases: how many lives can we save? Lancet. 2005;366(9496):1578–82.

    Article  PubMed  Google Scholar 

  • Thakkar J, Kurup R, Laba T-L, Santo K, Thiagalingam A, Rodgers A, et al. Mobile telephone text messaging for medication adherence in chronic disease. JAMA Intern Med. 2016;176(3):340–10.

    Article  PubMed  Google Scholar 

  • Topol EJ. Transforming medicine via digital innovation. Sci Transl Med. 2010;2(16):16cm4.

    Article  PubMed  PubMed Central  Google Scholar 

  • Topol EJ, Steinhubl SR, Torkamani A. Digital medical tools and sensors. JAMA. 2015;313(4):353–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • US Food and Drug Administration. FDA permits marketing of first system of mobile medical apps for continuous glucose monitoring [Internet]. 2016. [cited 8 Jul 2016]. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm431385.htm.

  • Visscher PM, Montgomery GW. Genome-wide association studies and human disease: from trickle to flood. JAMA. 2009;302(18):2028–9.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Internal Medicine, Foothills Medical Centre, University of Calgary, Room 933, 1403 - 29 Street NW, North Tower, Calgary, Canada, AB, T2N 2T9

    Pishoy Gouda MB BCh BAO, MSc

  2. Scripps Translational Science Institute, La Jolla, CA, USA

    Steve Steinhubl M.D.

Authors
  1. Pishoy Gouda MB BCh BAO, MSc
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Steve Steinhubl M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Pishoy Gouda MB BCh BAO, MSc .

Editor information

Editors and Affiliations

  1. Stanford University School of Medicine, Stanford, California, USA

    Homero Rivas

  2. University of Copenhagen, Copenhagen, Denmark

    Katarzyna Wac

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Gouda, P., Steinhubl, S. (2018). How Digital Health Will Deliver Precision Medicine. In: Rivas, H., Wac, K. (eds) Digital Health. Health Informatics. Springer, Cham. https://doi.org/10.1007/978-3-319-61446-5_14

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-61446-5_14

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-61445-8

  • Online ISBN: 978-3-319-61446-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation